Adam P
University of Minnesota Medical School, Minneapolis, USA.
Am Fam Physician. 1997 May 1;55(6):2146-53.
Diabetes insipidus is an uncommon condition characterized by polyuria and polydipsia. The symptoms and biochemical changes of this condition result from either a lack of antidiuretic hormone or renal insensitivity to its effect. Failure to produce or release antidiuretic hormone may result from cranial pathology, including trauma and surgery. The renal insensitivity to antidiuretic hormone that occurs in patients with nephrogenic diabetes insipidus may be caused by genetic factors, drugs (especially lithium) or specific disease processes. Patients may compensate for polyuria and nocturia by excessive water intake but show marked decreases in urine specific gravity and osmolality. Patients with severe and uncompensated symptoms develop marked dehydration, neurologic symptoms and encephalopathy. The water deprivation test is useful in diagnosing diabetes insipidus and in differentiating neurogenic from nephrogenic cases. Neurogenic diabetes insipidus may respond to nasal administration of desmopressin. Nephrogenic diabetes insipidus requires good hydration and monitoring of body chemistry. Thiazides and amiloride may relieve symptoms.
尿崩症是一种罕见的病症，其特征为多尿和烦渴。该病症的症状及生化变化是由抗利尿激素缺乏或肾脏对其作用不敏感所致。抗利尿激素分泌或释放不足可能源于颅脑病变，包括创伤和手术。肾性尿崩症患者出现的肾脏对抗利尿激素不敏感可能由遗传因素、药物（尤其是锂盐）或特定疾病过程引起。患者可通过过量饮水来代偿多尿和夜尿，但尿比重和尿渗透压会显著降低。症状严重且未得到代偿的患者会出现明显脱水、神经症状和脑病。禁水试验有助于诊断尿崩症，并区分神经源性和肾源性病例。神经源性尿崩症可能对经鼻给予去氨加压素产生反应。肾性尿崩症需要充分补水并监测身体化学指标。噻嗪类药物和氨氯吡咪可缓解症状。
